• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.19 no.1
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• pp.79-83
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• 2013

Background: Spasmodic torticollis is a disorder that is described by sustained muscle contractions causing repetitive and twisting movements, and abnormal postures in a single body region. The purpose of this case is to describe the manual therapy for a patient with spasmodic torticollis. Methods: The patient was a 64 years old man with an 3 month history of left side laterocollis spasmodic torticollis. No known genetic history or trauma. Prior to intervention, his score on the Western Spasmodic Torticollis Rating Scale (TWSTRS) severity score was 24, disability score was 20, pain score was 11. There is a noticeable distinction between left and right side cervical range of motion. The intervention consisted of manual therapy (MET, PNF) 3 times per week for the treatment during 4 weeks. Results: After intervention for 4weeks, his TWSTRS score and range of motion was improved quite a bit before therapeutic exercise. But symptoms are not improving sufficiently fast. Conclusions: Manual therapy is that MET and PNF is effective in improving for patient had spasmodic torticollis with laterocollis of neck.

• Journal of Korean Neurosurgical Society
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• v.38 no.5
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• pp.344-349
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• 2005

Objective : The Bertrand's method of selective peripheral denervation for spasmodic torticollis has already been established as being an effective and safe method. However, such effectiveness has not yet been established in Korea. The authors have performed several cases of selective denervation for the treatment of spasmodic torticollis and we hereby describe the details of the operative method to determine the effectiveness of the method. Methods : Ten patients who had the selective denervation for the spasmodic torticollis from October 1997 to December 2003, were analyzed. There were 4 rotational and 6 combined types [3 rotational plus retrocollis, 3 rotational plus laterocollis]. We performed preoperative electromyograms and neck muscle tonograms in all cases. The technique was used to involve denervation of the ipsilateral posterior paraspinal muscles. Denervation of the sternocleidomastoid muscle was performed on the contralateral side for rotational torticollis and on the ipsilateral side for laterocollis combined type. The surgery was followed by a rigorous physical therapy program. Results : The surgical results were divided into 4 groups labeled excellent, good, fair, and poor. There were 5 excellent patients who showed no detectable abnormal movements, 4 good patients who showed slight residual deviations or slight residual abnormal movements, and 1 fair patient with appreciable residual abnormal movements. Postoperative pain was well tolerated. There was no significant surgical complications. Conclusion : The study confirms that selective peripheral denervation for the treatment of spasmodic torticollis is a very useful and safe surgical technique.

• Journal of Korean Neurosurgical Society
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• v.37 no.5
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• pp.350-353
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• 2005

Objective: Various methods of treatment for idiopathic cervical dystonia have been tried in the past with unsatisfactory results. The authors report cases of five patients who underwent selective peripheral denervation for spasmodic torticollis. Methods: Between July 2002 and December 2003, 5 patients underwent surgery at St. Mary's Hospital for spasmodic torticollis. Age of the patient at the onset of symptoms ranged from 29 to 56years (mean 43.75years). Selective peripheral denervation(SPD) was performed at 7 to 11 months after the onset of symptoms (mean 8.75 months). A patient was considered to be the candidate for surgery if conservative methods were unsuccessful and symptoms persisted for longer than 7months. In addition, 2patients who refused treatment with botulinum toxin were also enrolled in this study. Results: Although one patient underwent reoperation, all of the five patients' symptoms were improved after the operation. Clinically, patients with retrocollis showed better improvement than laterocollis patients. Conclusion: Although injection of botulinum toxin is the first-choice in treatment modality, when surgery is required, selective peripheral denervation provides good results with minimum side effects.